Consequences of chronic kidney disease--mineral and bone disorder: a progressive disease.

Pathologic changes associated with chronic kidney disease - mineral and bone disorder (CKD-MBD) begin early in the course of renal disease and are typically progressive, despite the use of traditional therapies. A wide variety of potentially severe consequences are associated with the progression of this disease. These sequalae include parathyroid hyperplasia, parathyroidectomy, bone pain, fractures, vascular calcification, and cardiovascular events, with each independently associated with an increased risk for death. Nurses should be aware of the complications associated with CKD-MBD and the need to simultaneously achieve recommended targets for iPTHi, calcium, phosphorous, and the calcium-phosphorous product to increase the likelihood of arresting disease progression.